Here, Piggie, Piggie

Photo Credit: Madr@t Flickr via Compfight cc

The conversation last night was unusual, to say the least:

"Oh my God, I ate like a pig today."

"Me, too. I can't believe we ate so much."

"Man, we are going to have to do nothing but protein shakes tomorrow or something."

"Yeah, I totally feel you. We need to keep better track."

"Agreed."

So, what happened to cause this conversation? What horrible dietary sins did we commit? Did we visit Coldstone Creamery? Hit the all-you-can-eat buffet at one of our local casinos? Give in to temptation and each have one of the gigantic breakfast burritos from a local vendor?

In point of fact, no. We did none of those things. Actually, we cooked three meals at home, and each (barely) topped 1,000 calories for the day. Due to the high amount of fresh vegetables we ingested we also both went a little over 60 grams of carbs for the day.

It is a brave, new world that we are living in, post-surgery.

If you had told me a year ago that eating a thousand calories would make me feel bloated, overstuffed and concerned about over-eating, I would have laughed at you. No one can live on 1,000 calories, right? That is, like, anorexia territory, isn't it?

Yeah, apparently not. Once you've got somewhere between 1.5 (for bypass patients) and 4 (for sleeve patients) ounces of stomach to work with, the caloric intake suddenly becomes a LOT less important to you. Now, you are suddenly focusing on protein, protein, protein! (We did fine on our protein numbers yesterday, by the way - Lor had over 60, I topped out at 70.) Limit those carbs, raise that protein level, and the weight will just melt away!

Well, provided that you exercise every day. And take multivitamins every day. And make sure you stay hydrated, since you won't be getting much hydration from food sources anymore. And...

The total mind shift that comes along with surgery is really unexpected. They tell you that you are going to have to think about food differently, but it doesn't really hit you till that day after surgery when you are looking at a plate of 3 tablespoons worth of food and wondering how you are supposed to live on this. Until you keep having to smile and turn down a drink from a friendly waitress so you don't drink while you eat. Until you start carrying a phone app to track every single morsel of everything you ingest in a day.

And, suddenly, a few months later, you are wondering how you were such a pig as to ingest 1,000 calories worth of food. 

Mind. Blown.

Still Think I Need Those Protein Shakes,

- Hawkwind

Uncomfortable Answers

In the weeks leading up to and following our surgeries, Lor and I have become the friends and family ambassadors representing the nation of bariatric surgery. Sometimes the questions are asked in front of everyone at public gatherings, sometimes whispered as soon as no one is around, but the requests for more information keep on coming. The procedure itself is somewhat mysterious, and people are filled with curiosity.

For the most part, this is excellent - clearing up misconceptions about the procedure and the lifestyle changes that accompany it is probably the best way Lor and I can "pay it forward" for an experience that has had such a positive life-altering affect on us. We have friends and family members who are either considering or going through bariatric surgery and being able to help them along is awesome. Heck, I even write a blog about it, to get the information out there. We want this info to be spread far and wide.

But...there are a few questions that come up (and frequently get repeated) that demonstrate the misunderstandings surrounding bariatric surgery. And the answers admittedly don't feel real good when we know that someone is hoping that our answer will be exactly the opposite of what the truth is. It always makes me sad that someone who is considering bariatric surgery asks me a question that I know will immediately turn them away from looking into it any further. But, in for a penny, in for a pound - here are a few of those uncomfortable answers:

"Aren't you hungry all the time?": No...and yes. Let me explain. If I allow myself to dwell on thinking about food, I will crave it. It is as simple as that. Smells are an especially strong trigger for me - I can't smell pizza without wanting to eat one. Like, a whole pizza, I mean. But if I walk away, and think about something else, within 5 minutes or so I am no longer hungry. The hunger is not being generated by my digestive system at all (which is remarkably quiet if I don't expose myself to pizza), but by my mind. It is pretty weird, admittedly.

"If I have the surgery, when can I get back to eating normally?": By FAR the most common question we get asked. And the short answer is: Never. The surgery does not create a black hole in your abdomen that allows you to eat whatever the heck you want without consequences. The Lap-band, Sleeve, and Pouch all perform varying degrees of the same effect: negative reinforcement. There is less available space in your stomach, so you eat less. I personally find the sleeve superior (for me) because it also removes the majority of your ghrelin-producing stomach from your body completely. No hunger hormones mean no constant craving for food. (Something that plagued me for years before the surgery - I was literally hungry 100% of the time.)

"So, when can I start drinking Cokes/drinking alcohol/eating Krispy Kreme again?": Whatever the trigger food, we all want to know when we can start hitting it again. For some, it is soft drinks, for others ice cream. I, for example, will probably crave beer for the rest of my life. And the probable answer is "Never." Cokes and beer can't be had due to the side effect of carbonation expanding the area in the pouch, creating more room for food. But those Krispy Kremes and McDonald's french fries? They should be avoided as well, because it is so easy to vault off the rails and eat way too many of them at one sitting. They pass through the digestive track so quickly that you will never get full - leaving you eventually with an empty box of donuts and a feeling that you have just done a really bad thing.

"Really? I have to quit drinking?" Alcohol is no longer taking a pleasant 20-30 minutes to work its way into your system. It is no galloping through the stomach straight to your liver and then to your brain. One or two drinks is all it will take to get you very, very inebriated. And here is the real danger - we became obese because of addictive elements in our personality. It is so very easy to switch addictions from food to alcohol. The numbers of alcoholic bariatric patients are extremely high for this very reason.

"Will I have to exercise, like, every day?" Yup, afraid so. There are many stories of failed bariatric surgeries out there, each with their own sad tale about why the patient fell off the wagon and ate themselves back to obesity. Those stories all have one common element - these people stopped moving, and started eating. Exercise is critically important to the success of bariatric surgery - it not only keeps your metabolism up, but it also reminds you on a daily basis that you are doing this for a reason. As soon as you stop exercising, you will start regaining. It is as simple as that.

"Man, it sounds like your life sucks. Why would anyone have this surgery?" The saddest question of all - the questioner has given up on the idea of surgery now that they have been convinced that it is not going to be easy.

And, they are right - it isn't easy. But giving up the foods I loved was not something I could do on my own. It required external intervention to push me over that hump. And now, I may never have a Guinness or a chocolate cream pie again.

Instead, I can touch my toes. I can sit down without waiting for a chair to break. I can (almost) keep up with Lor and Vixen on our daily walks. I have spent more time socializing in the past 6 months than I did in the previous 6 years - once food ceased being the #1 priority in my life, room for a whole lot of other priorities was created.

Now, my life no longer sucks due to obesity. And that is why I had bariatric surgery.

Heck, I Might Even Get To Drink Real Coffee Again,

- Hawkwind

Non-Scale Victories

There is a whole new language incorporated into learning any new skill or interest. Mortgage lenders and borrowers must learn what is meant by APY and ARMs. Baseball players and fans have to dig into things thing OBP and RBI. And bariatric surgery patients need to ask someone what in the heck is meant by things like RNY and NSV.

NSV is one of the big ones for those of us on the far side of bariatric surgery. It stands for "Non-Scale Victory." Too many of us get completely focused on what our latest scale reading tells us, and don't pay attention to all of the other benefits that come along with the changed lifestyle that results from successful bariatric surgery and maintenance. Weight is important, sure. But weight numbers can stop dropping for a period of time (or "stall") as your body reconfigures itself. And wouldn't you hate to be so fixated on the fact that you've been stuck at a particular weight for a couple of weeks that you completely miss the fact that your waistline is suddenly down two inches?

NSVs don't even necessarily have to be about physical appearance. Maybe you can now walk to the top of a hill you couldn't before. Perhaps you've decided to take up biking for the first time since you were in junior high. It could be that you've made the decision to go to a reunion for the first time when you have skipped all the previous ones because you didn't want your classmates to see how much weight you had put on. NSVs come in various forms, and all are worth celebrating and sharing.

I have had a few myself. Some were appearance related: I can no longer wear 48-inch waist bottoms, for example. They fall right off me, even with a belt attempting to keep them up. Others are a little more practical - I was able to get out and work in my disaster area of a yard yesterday, trying to bring order out of months' worth of chaos. No gasping, no feeling faint, no needing to stop every 5 minutes to make sure I didn't fall over. It felt good to be able to actually finish a project, instead of leaving it only partway completed, to be finished "later". (Read: "never".)

My most profound NSV, though, has been entirely mental. For 12 years now, I have been shackled by the twin handicaps of epilepsy and obesity: a one-two punch that has not only interfered with my abilities to accomplish much, but has also drained away my confidence. Why even try, I have thought - I won't ever be able to succeed.

The beginning of the weight-loss process also brought about a change in my thinking. If I can really stick through this whole process, I thought, actually get rid of almost half my body weight, well, then - what can't I do? I was wise enough to not wait to "prove" anything to myself, but to start trying to succeed at something completely unrelated to weight loss, that I have wanted to do my whole life: writing professionally.

Since that decision was made, I have successfully published several articles, ghost written some blog posts, and, of course, switched Misdirected over to focusing on weight-loss rather than gaming. The results have been awesome. But the most exciting part is that I have been selected by Fiction Vortex to create one of their "serial boxes" - serialized science fiction and fantasy novels, released in 10 episodes over a period of 10 months. The writing is great, the stories are outstanding - and I get to be a part of it. My series is slated to be starting in January of 2017, and I can hardly wait - even though I haven't finished writing it yet.

Is this an NSV? You bet it is: if not for the decision to pursue weight loss surgery, I would never have had the confidence to put myself out there as an author. Proving to myself that I could go through the preliminary diet changes, go through the surgery, and then commit to the lifestyle changes that will be required showed me that I am not hopelessly broken: I can still pursue dreams, just a little more slowly than most people. If I never lose another pound from this point forward, it will still have been worth it.

Though, just for future reference, I apparently still have about 60 pounds of weight loss to go. But, you know, that would be a "Scale Victory". 

Proof That You CAN Teach An Old Dog New Tricks,

- Hawkwind

A Game Of Inches

Photo Credit: Max Garçia via Compfight cc

(Warning: Young children, those easily offended, and those preferring not to engage in/read about human reproductive activity should probably just skip today's blog. You have been warned!)

During your bariatric surgery preparations, and probably forever afterwards, you are going to be friends with the measuring tape. You will get to be astonished as you watch your hips and stomach shrink due to fat reduction, and depressed as your arms and calves do the same things due to muscle loss. It is a useful tool to keep track of unexpected muscle loss, ongoing fat burning, and (eventually) stabilization as your body gets used to your new digestive system and dietary practices.

However, I have been noticing in recent weeks that, while most of me is reducing in size, one area in particular is apparently gaining. Positive that I must just be hallucinating, I went in search of answers.

And I found some very startling ones: apparently weight loss in males has an unusual side effect - for every 30 pounds of weight (or so) lost, the apparent size of the penis grows by about an inch. Now, I know from my limited understanding of biology that the human genitalia isn't supposed to get larger over time - what you have is what you have. (Look up "penis enlargement" some time on Google to see how popular the subject is.) So, what gives?

It works something like this: Imagine a six-foot pole, set up as a fence post so that only 5 feet of it are exposed. If the fence isn't maintained, dirt, leaves, and other debris gather around the base of the pole. Enough gathering of "stuff" around the base, and eventually you can only see the top 2 feet or so of the post. When your spouse gets after you enough and you get out in the back yard with your rake and your shovel, after a few hours you can see all 5 feet again.

So, the post is the male genitalia, the debris is the fatty deposits in your abdomen (due to your lack of maintenance), and the rake and shovel are your surgery and your lifestyle changes. All of a sudden, that fence post appears to be growing.

Every 30 pounds of weight loss works out to exposure of another inch of your equipment that had previously been inaccessible due to fatty deposits. As of today (I checked) I was down to 240 pounds - a total loss of 62 pounds since I started this process.

I will let you do the math.

But, the really startling thing is that I am not done losing weight yet. My target weight (according to my doctor, mind you) is 185 pounds! That is nearly twice what I have lost already. Seriously, now - a potential weight loss of 117 pounds, divided by 30 works out to 3.9 inches! Imagine the possibilities...

Now why, for heaven's sake, is this not being marketed as one of the major benefits of weight loss surgery? It was never mentioned to me by anyone on my surgical team. I have frequently remarked on the lack of males undergoing this process - roughly 2 men to every 8 women go through with bariatric surgery. Talk up the fact that you can increase the size of your equipment as a result of this surgery and there will be lines of men out the door and around the corner waiting to sign up.

That's just how men are. Despite what all the pundits and well-meaning sexual partners may tell you, size matters. Heck, did anyone watch the Republican debates? These were men competing to be the leader of the most powerful nation in the world, comparing sizes on national television. It isn't just for locker rooms in high school.

Bariatric surgery needs to get behind this as a marketing device immediately. You know, for the health and well-being of all my fellow overweight men.

Yeah, we'll go with that.

Patting Myself On The...Back For Having Weight-Loss Surgery,

- Hawkwind

One Last Look Ahead

Well, this is it.

After 5 months and 90 blog posts, this is the last post I will make before the day of my surgery (July 25, 3 days from today.)

On Monday, at 7:30 AM (MST), I will get taken back to pre-op, and within a couple of hours, my whole life will change. Again. After 80% of my stomach is removed, I will get moved out to the general population of the hospital for a couple of days. There, I will sleep or shuffle slowly back and forth around the hallways, hauling my IV rack around behind me. Until, on Wednesday, they send me home, where I will collapse into a real bed for about a week or so.

Where am I getting this vision of the future from? I just watched Lor go through it, about 5 weeks ago. It took her three weeks to really get her feet back under her, and I know darn well she is tougher than I am. I am resigned to some quality bed time post-surgery.

I will continue to keep everyone informed as usual - my next blog post will be from the hospital, either immediately pre- or post-surgery. Let's go with "pre". Lord only knows what I would say if I wrote something immediately after surgery. Anesthesia can do some strange stuff to the mind.

How do I feel about it? A mixture of dread and relief. Dread because I hate hospitals sooo much. Relief because I will at least be done with waiting. Lor even informs me that I will be done with feeling like I am constantly starving, so there is that to look forward to. 

Curiously, I am not afraid of the procedure itself. We have picked some amazingly competent surgeons in a world-class organization focused exclusively on bariatric surgery. After some of the horror stories we have heard and read about these procedures being performed by less experienced doctors, we are so glad that ABQ Health Partners Bariatrics was available to us.

I am, admittedly, kinda worried about the "5 shanks and a boot knife" results, but 5 weeks out Lor is already rocking and rolling with pretty much full use of her core muscles, so I suppose I have real evidence in front of me that it isn't as bad as it looked. 'Cause boy, did it look bad.

Mainly, I am ready to get home on Wednesday, so I can lie around and binge-watch all the shows I have been stacking on Netflix, and go through my old DVD collection. 

I will keep everyone in the loop as things progress. Only 72 hours to go.

Ready For That Tasty Hospital Food,

- Hawkwind

Wheels Up

Well, it is official. I've been through the classes, I've done the 3+ months of reduced carb diet, I've even received the letter from my insurance company telling me that I am approved. Only one thing left to do before surgery.

Today, the liquid diet phase begins.

For those who have joined us recently, the liquid diet phase means this: every "meal" I have, for the next two weeks, is a protein shake. To break up the monotony, I also get to have a few snacks every day: one cup of yogurt, up to 4 sugar-free popsicles a day, and/or all the broth I want. I also need to be ingesting at least 64 ounces of water a day, but I am an old pro at that by now - I've been doing it since March or so.

We have some very recent experience with this liquid diet thing - Lor did it just about 6 weeks ago. It is not pleasant - she was constantly craving the ability to chew anything. Plus, the adjustment of one's body to the reduced calorie load has a bit of a negative emotional side effect.

In other words, I can expect to be cranky as heck for about the first week of my 4 weeks on nothing but liquids.

The results are pretty profound, though. From the point where Lor started the liquid diet to where she exited the hospital, a period of 3 weeks, she dropped a total of 13 pounds - a little over 4 pounds a week. 

I've now been at this for 25 weeks, since I started the pre-surgery diet early, at the same time Lor did. I've managed to lose 41 pounds in that time, averaging about 1.5 pounds a week. Our surgical team constantly tells us not to compare weight loss numbers, but I am going to anyway - If I am down another 13 pounds at my post-surgical weekly weigh in, 3 weeks from today, I will have lost 54 pounds total.

I will be below 250 pounds for the first time since 2004.

When I weighed around 250, I looked something like this:

2002 - Somewhere between 240 and 250 pounds.

Yeah, I'll take that. 

Protein Shakes, here I come.

Wishing There Were More Interesting Flavors,

- Hawkwind

Surgery: It's A Thing, Man.

But you should see what the other guy looks like.

It has been noted in the past that significant life events seem to happen in groups. Boy howdy, does that seem to be getting proved out around these parts. Here in our household both of the lovely ladies I cohabitate with, Loralia and Vixen (pictured above), have now had surgery in the past two weeks, and for both of them, the surgery has looked like No Fun At All. Leaving me to speculate on the upcoming surgical procedure that awaits me in 25 days. 

I am not sure where I got this impression that surgery was going to be no big deal. It has certainly not been my experience in the past. My VNS installation and later repair were certainly not life-shattering surgeries, but my knee surgery in 2014 most certainly was - I was in pain for months afterwards, and to this day have to wear a knee brace when expecting to walk anything more than a short distance. Surgery is invasive. It hurts. And it takes a long time to recover from.

Watching my ladies suffer through the recovery from their surgeries has made me hyper-aware of the fact that this train is coming for me too. Once upon a time I had been concerned only with the difficulty of the liquid diet before the surgery and the greatly reduced diet post surgery, not thinking too much about the procedure itself. Nowadays, I find that I am thinking more and more about the surgical process, and wondering what it is going to do to me and mean for me.

Just like Lor, I am going to have 5 holes punched into my abdomen to insert instruments, along with a sixth just below the breast line to work on a hiatal hernia. 80% of my stomach is going to be chopped off, then pulled out of my body via a slit only about an inch wide. (How is THAT for weird?) The hole that remains is then going to be stapled shut, creating a tube-sock looking stomach remnant about the same size of a small banana. My belly will inflate like a gigantic beach ball (again) due to all the gases being pumped into my system. The surgical team will then super-glue the holes on my abdomen shut (not a joke - I have seen the stuff on Lor's post-surgical wounds), and call it a day.

Just like Vixen, I do not respond well to anaesthesia. It takes me longer than normal to recover from the effects, and it occasionally causes me to have seizures in recovery or shortly after surgery. Recovery is painful and takes a few weeks. And I am not a great patient, which will surely test everyone's patience with me.

These are the things that go through my mind as I have been caring for first Lor and now Vixen after their surgeries. I am doing my best to be just as kind and considerate as I can be - trying to develop myself a positive balance on the post-surgical care karma card. I am not exactly afraid of the surgery (though I am still quite afraid of the hospital where I will be staying for 3 days.), but I am no longer thinking of it as a short and easy phase that will be passed through without any trouble.

I just keep reminding myself that this, too, will pass. 2 months from today I will be looking at this whole thing in the rear-view mirror, right? Let's hope that I get through it as well as the ladies in my life have.

Trying Hard To Imitate My Stoic Ladies,

- Hawkwind

It Is Still Friday, Right?

2 PM in Albuquerque, NM. The recovering patient is asleep in her own bed, my mother-in-law is cleaning my house from stem to stern, and I am hiding in my office, "working."

It has been a hectic 24+ hours since I last posted here. Lor was walked around the hospital floor several times last night, discovered the reduced capacity of her new stomach pouch the hard way (no room for error on drinking just a little too much anymore!), and been awakened by hospital staff asking "Are you sleeping?"every two hours.The hospital staff members have been great, but anyone can tell you that a hospital is no place to get well.

So, by 6 AM this morning, Lor, her mother and I were all sitting around the hospital room, waiting for her release. A doctor showed up promising freedom at about 7 AM, and by 11 AM or so (you know, hospital time) Lor was finally out the door and on her way home. She arrived here at noon or so, and is now resting as comfortably as you can with 5 new holes punched through your abdomen, and the MIL and I are doing the best we can to avoid interrupting that rest. 

Lor is actually doing pretty well today, all things considered. Her mobility is good, she has had little interest in pain meds, and her biological functions are slowly returning to normal. Once the post-surgical inflammation recedes a bit we will get a "real" idea of what her new stomach capacity is. Right now she can only have a couple of sips of anything before she is forced to quit for half an hour or so. It seems slow to us, but she is right on target according to her medical team. We are doing our best to not get in the way of the folks that do hundreds of these a year, even when certain things seem weird. Not easy for control freaks like Lor and I.

For this weekend, we plan to just let her recover, walk her around the house (slowly), and get this healing process underway. I continue to hope for a steady recovery for her, but knowing her tendencies it may be necessary to apply the brakes now and again. If she had it her way, she would be ready to run a marathon tomorrow.

I will let everyone know how the process is going on Monday morning. Enjoy your Father's Day weekend!

Very, Very Tired,

- Hawkwind

There's Got To Be A Morning After

6:00 AM. So early that even the nesting birds are wanting to know "What the heck are you doing up so early, man?" as I walk by their nests.

The good news, since I know you have all been waiting for it, is that Lor came through the surgery 100% successfully. Her surgeon nearly gave us all a collective heart-attack when she emerged after only 45 minutes of surgery, but, no, the news was nothing more significant than that the surgery was completed, and we could see Lor shortly. There was much rejoicing, Facebook posting, telephone calls, etc. Others in the waiting room probably thought we were celebrating an ethnic holiday.

There isn't any bad news exactly. But there were some...surprises.

Post surgery, I think we were expecting a glowing, healthy person who was now totally committed to weight loss. What we got was someone who was in major amounts of pain, and suffering from the effects of anasthesia. Stupid of me to expect otherwise, but I was taken aback by the fact that the preson who went in for surgery was not the person who came out. Though she had returned to normal within a couple hours, it wasn't something I was mentally prepared for, and maybe should be included in the pre-op "training" - "Dont take anything said in the first couple of hours after surgery seriously."

A little later on yesterday, I got to see the reason that Lor was in so much pain. My first glimpse of her post-surgical abdomen gave me a serious shock. She looked, bluntly, like she had been in  a knife fight.

I know, I know - what the heck was I expecting after she had scopes inserted into her abdomen in 5 different locations? What ever I was expecting, it wasn't this. Big bruises surrounding obviously punctured tissues, all across her tummy. I don't know how she is carrying on conversations, or breathing for that matter. I have a certain amount of experience with knife injuries (how is not important here), and these ones look like they are no fun at all.

So, next time someone asks me if bariatric surgery hurts, the answer should be an emphatic "yes". Got it.

We also had some administrative snafus that wound up with Lor finally getting comfortably settled in her bed, just in time to be informed that she had to move to a different room. On a different floor. Of course. Out came the wheelchair, the dance of disconnecting cables and monitors and leg-squeezers, and she was shipped up one floor, to the room literally directly above the room she had already been in. Administrative logic never ceases to confound me.

Lor's Mom took the overnight shift last night, and they are both currently still asleep 5 floors above me. I have camped out here in the cafeteria to jot all this down after sneaking out of my parent's house at 5:30 this morning to drive the 5 miles over to the hospital Lor is at. Thank God for our families - this would have been a nightmare without all the familial help and support we have received.

Thanks also to all of you - Lor was the subject of prayer chains, the focus of positive energy flows, and the receipient of remote healing energy from across the country. I can't thank everyone enough for your care and interest in the well-being of the person who is the center of my life. My heartfelt thanks to all of you.

Wondering If 7 AM Is Still Too Early,

- Hawkwind

PS - No pics for the next few days, my poor Kindle isn't the best tool for blogging.

The Hunger Games

Photo Credit: Elaine Russo - Delizie! Arte com Açúcar via Compfight cc

Things are strangely quiet here in the household, the kind of silence that descends in a horror movie right before something lurches out of the shadows. Think Rime of the Ancient Mariner kind of calm. We are 24 hours into Lor's "liquid phase", and...

...What's that? The great majority of you have no idea what I am talking about? Let me back up a bit, then.

Any bariatric surgery is surrounded by several periods of time (or "phases") in which diets are radically changed to either prepare for or recover from surgery. We have been in one of those phases for months now - the low carbohydrate phase, where patients are supposed to drastically reduce their carb intake for the 3 months preceding surgery. However, 2 weeks out from surgery, another major dietary shift occurs. The patient is now required to spend two weeks eating (drinking, really) nothing but protein shakes, clear liquids (like broth), and water. Why? In order to shrink the size of the liver, which has to be moved out of the way (laparoscopically, of course) in order to perform any bariatric surgery. The smaller the liver, the easier it is to move around in the abdominal cavity. But the patient still requires high amounts of protein to stay alive, so protein shakes and vitamins it is.

Immediately upon release from the hospital the patient will go back on the "all protein shakes, all the time" diet. This is to give the digestive system time to recover from the traumas that have been inflicted upon it, but also means that the patient will spend 4 weeks on nothing but protein shakes and an occasional yogurt. Many successful patients report that after they are done, they never want to look another protein shake in the face as long as they live.

We are now 24 hours into Lor's protein shake phase. And, while I had anticipated what would be happening to Lor, I hadn't realized what was going to happen to me as well. You see, I will not be eating any food that Lor loves during this 4 week period. Why torture her like that, right? What I had not anticipated is that, cooking boring food for one, I would be really reducing my caloric intake as well. For example, yesterday, Lor got a whole 750 calories in protein shakes. But, I was right behind her, managing only 950 calories in "real food". Plus, she hit her 60 grams of protein target for the day - I actually missed mine.

I am little perplexed as to what to do next, honestly. Do I increase my intake to make sure I stay sane and stable for the next month? Or do I stick it out, suffering in solidarity with my wife like I had originally planned? I feel pretty decent now, I must admit - I have not suffered through the constant hunger that nothing but protein shakes creates. I think I will just wait and see what happens next.

One thing is for sure, though - the next 4 weeks are going to be more interesting than I initially thought they would be.

Hoping Lor And I Do Not Cannibalize Each Other,

- Hawkwind

The Struggle To Stay On Track

Photo Credit: Patrick Dirden via Compfight cc

Ten percent of me is gone.

I mean that in a good way, I suppose. As of Monday of this week, my pre-surgical diet and exercise program has resulted in me dropping from a high of 302 pounds down to 272. My friends and family are all congratulating me. I should be elated. But I am not.

Because now I am having doubts about my upcoming surgery.

The real problem began about a month ago, when I was informed that there was a mysterious "holdup" in processing my claim through my insurance. My (federally required) psychological exam had never been approved by Blue Cross/Blue Shield. Upon calling the insurance company, the mystery deepened - my claim was "pending", and had been since the middle of April. No one could tell me why. The insurance reps seemed completely baffled. "Call your doctor." was their advice.

I called my doctor, who said he would get it straightened out. And then...nothing. For two weeks I have been waiting for an approval to move this whole process forward. and have heard not a word. Without the psych eval I can't have surgery - and if it doesn't take place by mid-June, the whole process will be delayed for who knows how long.

Upon talking about the problem to family and friends, I keep hearing a similar train of thought: I am doing great on the pre-surgical diet, so I could potentially stick with that even if the surgery never gets approved.

Did you catch that? It goes by pretty fast. The general thought is, if I am not approved for surgery due to an insurance snafu, I can just press on and lose the weight on the basis of the work I am already doing. Sounds very encouraging, until I ask myself: "If I can do this without surgery, why am I having the surgery?"

It is not as if I haven't tried to lose this weight before. I've been obese for better than half my life, I have had the opportunity to try just about everything. I finally fell into weightlifting in my late 20s and early 30s because I could be obese and functional at the same time.  But, something has always come up that interferes with my success, Seizures. Boredom. Transportation problems. A couple of very bad food intake days leading to frustration after which I would give up. Believe me, I have been there and done that. I have turned to bariatric surgery hoping for a final solution, a weapon to use against my own food issues.

So, what happens if that weapon never materializes? Will I be able to commit to these changes without the physical modifications I was counting on?

If I can't succeed without surgery, how it is going to impact me watching Lor go forward without me?

If I can succeed without surgery, why the hell am I am going under the knife in the first place?

The Wheels In My Head Go Round And Round,

- Hawkwind

The Struggle Against Ignorance

As bariatric patients, we have a lot to deal with. New diets, new exercise regimens, and new ways of thinking. Our insides are being re-routed or removed, depending on the procedure, leaving us with lengthy recovery and relearning periods of time. And ever after we will be forced to make choices that reflect the physical and emotional changes that we have gone through - that or suffer a resurgence of weight as we return to bad habits. Seems like enough to deal with, right?

Not according to a large percentage of individuals out there in the world who perceive obesity surgery as "cheating". If you have surgery to correct obesity, the thinking goes, you are just lazy. One glorious example was related to us in a bariatrics group - a woman who had lost over 100 pounds post-surgery decided to join a local gym, overcoming her self-esteem and body issues. The trainer she was assigned was blunt: "Did you lose that weight through diet and exercise, or just go through surgery?"

This from a physical trainer - someone supposedly educated in assisting people with their weight loss and fitness goals. Apparently she stopped paying attention during class to polish her self-love. There are reams of studies out there demonstrating that obesity is more than laziness. The condition itself prevents us from high-caloric burning activities, which leads us to depression, which leads us to seek comfort in the very thing that caused our condition. It is very similar to drug addiction (another maligned and misunderstood condition, but my soapbox can only reach so high.) All this was apparently somehow missed by this stunning example of physical training at its worst.

"You don't see obesity and food allergies in Africa." wrote another charming individual commenting on an article about a successful bariatric surgery patient. Since starvation exists, he theorized, it was obvious (to him) that the only thing needed to cure obesity was a calorie-restricted diet. It is all about willpower, was his thought.

Such an argument should not even exist outside of an elementary school playground. How many of the starving people in the world (not just in Africa, you budding racist) are choosing malnutrition? Not a single one, I would guess. They, too, would love to exist in a food-rich culture like ours - where they have choices about what to eat on a daily basis. They are not "thin" because they have chosen to not eat. There is no willpower or exercise involved. Where now is your "healthy lifestyle?" This man was too stupid to be allowed on the Internet.

(By the way, this statement is not meant to suggest that there is no hunger or malnutrition within our food-rich societies. That it exists at all is a travesty, but, again, one soapbox at a time.)

Bariatric surgery is not a shortcut to a "slim and beautiful" self. In fact, we not only get the intestinal re-arrangement of surgery, but we then get to do the very same food restriction and daily exercise these bigots claim we are avoiding. We don't go through surgery and then eat whatever we want for the rest of our lives. We go through surgery and then spend the rest of our lives eating tiny amounts, usually sacrificing the foods we loved the most. Food becomes fuel, not necessarily a source of pleasure and enjoyment any longer. And, thanks to the lifetime of bad habits we previously embraced, we will almost certainly never look like supermodels. Does that sound like a "shortcut" to anyone here? 

The ignorance is everywhere. When you encounter it, your initial reaction may be to just run away from it in embarrassment. I would ask you, as a fellow bariatric patient, please do not respond as if you have something to be ashamed of. You do not. You should be proud that you have taken control of your health, and made some very tough decision in the name of caring for yourself and your loved ones by giving yourself the tools needed to return to a healthier, more active lifestyle. Hold your head high, and don't flee from idiots and the misinformed.

Instead, though it may be difficult, educate. Though there are bigots out there who will not be convinced no matter what you say (about anything, really), there are far more people who simply do not understand the procedures, the lifestyle changes, and the commitments that are required to be a success story after bariatric surgery. Take a minute to explain what is really happening to you. Ignorance is only overcome by one good decision at a time.

Sort of like obesity.

Still Wishing I Could Boycott That Trainer's Gym,

- Hawkwind

A Bittersweet Birthday

Normally what is happening over on Lor's side of the journey to bariatric surgery is closed off from public view: as I have said before, it is not my story to tell. But, this last weekend was significant enough that I have asked for, and received, Lor's blessing to talk a little bit about what I saw over Lor's final pre-surgery birthday.

Lor's journey to bariatric surgery is significantly different than mine. She is active. She is proud of her looks and her shape. She is a fabulous cook, and especially enjoys baking - bread, pies, cakes, you name it, she is the one that gets the call when someone in the family needs a dessert for a special occasion. She is nowhere close to where I am on the BMI scale, and would be perfectly content to stay there. So, why, then, go through the huge life changes that surgery forces a person through? Why give up freedom to choose her own path, and instead be forced into the regimented lifestyle that she will live with for the rest of her life?

One word: Diabetes. It runs rampant in her family, it has killed several of her loved ones, and despite her youth, she has been struggling with it for years. She has taken the high road and chosen a more difficult lifestyle recommended by her doctors (and her family) so that she can remain healthy and vibrant for decades to come.

She was treated to two different birthday meals over the weekend, one by my parents, and another by her best friend. From my parents, she received a life-saving gift: a new digital scale for us to use in food prep. Our old postage scale had been returning suspicious results for quite a while, and verifying weights between the two demonstrated that we had been WAY off in many of our food measurements in daily prep. (2 oz of Kale does not fill a small child's cereal bowl, for example. It overflows the bowl and creates piles on the counter.) Lunch was filled with encouragement and speculation as to how different her next birthday would be. Though she smiled and laughed, 25+ years of experience with her showed me the tension in her shoulders and her face - her surgery does not represent freedom like mine does. 

Dinner was at a local sushi house, and was a whole different experience. Her best friend also suffers from pretty severe dietary restrictions, and here the conversation was able to deal with fears and doubts realistically - with a pro who has been there and done that in having to make changes to her life that were forced upon her by health issues. I am sure the bottle of sake didn't hurt the spirit of full disclosure much. Here, too, was another comforting thing: this was not the last time Lor would ever be able to eat at this particular restaurant. Though California rolls will vanish from the future menu, many other things (sashimi, for example) will not have to. For the first time in weeks, we were not having a "food funeral" at a restaurant. The difference in atmosphere was huge: here was a place we would be returning, not another thing we were waving goodbye to.

All weekend long she was deluged with messages from friends and calls from family members, all saying the same thing: we are proud of you and we support what you are doing for yourself. And, by the way, happy birthday. It was amazing to watch. I am always proud of her, but this weekend I was really proud of the community around her - admiring, encouraging, uplifting. You have made me very proud to also be a member of the "Loralia Fan Club."

Wishing Everyone Had Friends And Family Like Lor's,

- Hawkwind

Not Living, Just Surviving

We've had quite a few conversations with friends and family members in recent days, talking about the nuts and bolts details of the upcoming surgeries. While the great majority of these conversations have been strongly supportive, a few have been...less so. One recent conversation with a family member springs to mind.

The family member in question had lots of questions about what I was going to be giving up as a bariatric surgery patient. "So, no more beer, ever?" he asked at one point.

"No," I explained, "no carbonation at all. It makes the stomach pouch expand, and you wind up right back where you started."

"So, like, no Cokes either?"

"No, none. I need to avoid coffee too - caffeine is a diuretic, and staying hydrated is super important after the surgery."

"No coffee!" he exclaimed. "I need coffee in the morning to wash down my breakfast!"

"Yeah," I explained, hanging on to my patience with both hands. "Can't really wash things down while eating anyway. You can't drink while you are eating at all. You need all the space in your stomach at meals for food."

He leaned back and crossed his arms, clearly disgusted. "No beer, no coffee, can't even drink when you want. That's not living, That's just surviving."

Now, I personally have a strong opinion on survival - I think it beats the alternative. And, I understand that the relative in question isn't suggesting I should bite the dust in the name of drinking beer. It is a question of quality of life that is being raised here, not life vs. death. And, as it happens, I have a certain amount of experience in evaluating quality of life. Over a decade of dealing with Epilepsy has had me questioning many times: Is this really worth it? And, despite all the things that Epilepsy has forced me to give up, I have always come back with the answer that life itself is worth continuing, even without the various components that I used to previously enjoy.

And, here's the thing: Bariatric Surgery may not only extend my life, but it also has the potential to give back many of the things I have lost previously. Reduced weight could increase my activity level enough so that I could start weight lifting again. It could remove my dependence on a machine to help me breathe at night while I sleep. It could mean a reduction in my arthritis symptoms, meaning I am no longer in constant pain. Heck, it even has the potential to reduce the dosage of my anti-seizure meds - meaning that the "brain fog" I am constantly in might be lifted somewhat. Sounds an awful lot like a new lease on life, where I am currently just surviving.

Is that worth giving up Starbucks and Samuel Adams? Yeah, I think so.

Considering Switching to Bushmill's,

- Hawkwind

PS - If you have a family member who is considering bariatric surgery, be supportive - a good support structure is a necessity to be successful.

A Look Behind The Curtain

Anyone who has spent even a small amount of time following Misdirected knows that I kinda keep things on the DL (Down Low - keeping things hidden, for those who missed the class on Speaking Like The Cool Kids.) I use a pen name, major characters in my life are referred to by nicknames or pronouns, etc. It isn't that I have any particular desire to remain a secret. Far from it, in fact - those who don't know me can work out my real name just from looking at my email address over there to the right somewhere. But I have no wish to expose any one else's life accidentally - as my Mother likes to say, "Those are not my stories to tell." Where my stories intersect with other lives is where I get real nervous about what is safe to talk about.

Imagine my surprise when the love of my life, Loralia, starts speaking to me last night about bringing up a subject that I have specifically left completely unmentioned thus far. Lor is intimately involved with Misdirected - she acts as my copy editor, thesaurus, and memory bank all rolled in to one person. So, she is well aware of anything that I have said or allowed to remain unspoken in these posts. And last night she mentioned to me that I should talk about something pretty relevant to my recent posts. I countered that the information was not really anyone else's business. She was firm: "I don't want anyone to think there is any shame in what we are doing here." I conceded.

So, the news is this: I am actually not going through Bariatric Surgery alone. Lor is also taking part in the process, with her schedule running about 6 weeks ahead of mine. While my surgery will be taking place in August, hers will most likely take place in June.

Our surgery coordinator and our surgeons are delighted - couples that go through the surgery together have a vastly higher long-term success rate than individuals that have to go it alone. With built-in diet monitors and accountability partners right at home, the temptations to fall off the wagon are greatly diminished. And the support system that is required for encouragement and validation? No further than across the dinner table.

Now, this has created some worries in our household. Lor has been a long-time opponent of body-shaming, and has worked diligently for decades with friends, family members and clients to help them to love themselves as they are, rather than cave in to societal expectations of what a "perfect" body should look like. Lor is beautiful and she knows it, and she has helped so many other women understand the beauty they already possess without diets, without input from Vogue and Cosmo, and without...surgery.

But, the hard truth of the matter is that Lor's family has a long history of Diabetes. Lor's family has lost several members to the disease already. And Lor's case of Diabetes has gotten so bad that she recently had to retire from Massage Therapy - her joints and musculature have atrophied so badly that she is in constant pain, unable to do the work she loves any longer. This is hard news for a young woman with many years of life left in front of her. And, one of the best treatments for this disease is - Bariatric Surgery. The decision, for Lor, was not at all about the cosmetic effects of surgery. Same as with me, Lor wants to be able to have some "quality" restored into her Quality of Life.

The two of us found it very odd that, while I was waiting for my initial appointment to be evaluated for surgery, Lor's family practitioner suggested out of the blue that Lor be evaluated as well. Lor's doc was a LOT more aggressive than mine, and moved Lor over into the fast lane, getting her evaluated, approved, and started on the process while I was still waiting for my initial eval. Lor is basically 6 weeks ahead of me on this journey, and I have (selfishly, yes) enjoyed the benefits of being able to see what is coming down the road for me through her eyes.

Thanks again to everyone for your support and interest in this whole process. We both appreciate the encouragement through what has been a pretty mind-blowing process so far.

Envisioning Life Without Diabetes and Arthritis,

- Hawkwind and Loralia

The Internet Has Spoken

A little history: As of August 10 of last year, after 3+ years of existence, Misdirected hit 10,000 total page views.

Last night, only 7 months later, we kicked over 15,000 page views.

We went over the tipping point, in part, due to a tidal wave of views that came in yesterday - a single post that brought in more page views and more feedback than any other thing I have written. This was not a gaming post, not a post about epilepsy, no insightful social commentary on my part. It was literally a few paragraphs on the subject of starting the journey towards bariatric surgery that drove more interest here than any other 3 previous posts combined.

So, what does this mean for me, and for the future development of Misdirected?

I had honestly not intended to shift the focus of this blog. My original plan was to provide occasional, brief updates on my progress pre- and post-surgery, sprinkled in amongst the "real" content of the blog. But there is more interest in this subject than in anything else I have written. So, the question now becomes: Am I writing this blog as a diary, or really trying to communicate with the world? (I find it ironically amusing that even the blog title could be taken in the context of weight-loss surgery)

I remain a gamer. I remain disabled due to epilepsy. But, I also remain a person struggling with obesity and with my decision to address this issue via surgical means. Accordingly, I will probably be spending more time talking about obesity and the surgical process than I had originally intended. I have been a long time advocate for those disabled with epilepsy - I think my advocacy has room to expand a bit.

One thing I do need from my readers - I have had a couple people express their disappointment that I will not be doing a weight-loss related video blog. Is this something that the rest of you are really interested in? Drop me a line or leave me a comment on Facebook to let me know.

And, don't worry. I will still keep wiping out parties in XCom 2 and Darkest Dungeon and coming here to complain about it.

Re-Balancing,

- Hawkwind